Student Early College Application - Early College

Student Information

Student name*

First Last

Date of birth*

Gender*

Student personal email*

Student Cell phone number*

Mailing Address*

Street Address Address Line 2 City State ZIP Code

I am a:*

Maine resident
an out-of-state resident

Is the student a U.S. citizen?*

Yes, I am a U.S. Citizen
No, I am NOT a U.S. Citizen

Name of high school attending*

What is your date of graduation?*

List the first course you wish to take. For example: ENG 101 or MAT 126*

If you choose to take a second course, Please note that summer courses are condensed and take extra time for study and assignments. Please list the course you wish to take. For example: ENG 101 or MAT 126

Course drop acknowledgement (please review this section carefully)*

I have read and understand the drop policy disclosure below

These classes are full, college-credit courses. They become part of your permanent UMaine system record and the GPA will remain on the UMaine transcript. Failing to drop the course within the drop period deadline may result in a poor grade for the course. This grade will remain on your permanent UMaine transcript and as part of your GPA. You MUST email our office at um.earlycollege@maine.edu, indicating the desire to drop. DO NOT ask the instructor to drop the course. A confirmation of the dropped course will be emailed to you once the drop has occurred.

Student's signature*

Type name in caps above. This will serve as a digital signature. With this signature, you give permission for your high school GPA to be given to UMaine Early College Programs for demographic purposes. You further understand that this Release of Academic Progress and high school GPA are necessary to determine program eligibility, and are required to complete the application for the University of Maine Early College Programs. You also give permission for your academic progress in UMaine course(s) to be released to your high school guidance office.

Parent Information

Parent or guardian name*

First Last

Parent or guardian phone number*

Parent or guardian email*

Parent/guardian financial disclosure agreement*

I have read and understand the financial disclosure below

I, the parent/guardian, understand that the tuition costs not covered by any additional financial assistance are my responsibility to pay to the University of Maine. These costs may include textbooks or lab materials required by the course being taken. If my student drops a course after two (2) weeks, I may owe the university a portion of the original bill (amount will vary according to date of withdrawal).

Parent or guardian's signature*

Type name in caps above. This will serve as a digital signature. With this signature you verify that all information entered in this document is accurate.

Today's date

Early College

First-Year Early Start Program Application

Student Information

Parent Information